ArticleAIDS (London, England)2019
The Estimation and Projection Package Age-Sex Model and the r-hybrid model: new tools for estimating HIV incidence trends in sub-Saharan Africa.
Article in AIDS (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- HIV prevalence in transgender women and cisgender men who have sex with men in sub-Saharan Africa.AIDS (London, England) · 2026Pooled it
- Declining HIV incidence in sub-Saharan Africa: a systematic review and meta-analysis of empiric data.Journal of the International AIDS Society · 2021Pooled it
- Patient-level forecasting of geographic atrophy with a biologically grounded Gompertz model.medRxiv : the preprint server for health sciences · 2025Article
- The changing cost-effectiveness of primary HIV prevention: simple calculations of direct effects.Journal of the International AIDS Society · 2025Article
- Global, regional, and national burden of HIV/AIDS, 1990-2021, and forecasts to 2050, for 204 countries and territories: the Global Burden of Disease Study 2021.The lancet. HIV · 2024Article
- Dynamic models augmented by hierarchical data: an application of estimating HIV epidemics at sub-national level.Biostatistics (Oxford, England) · 2024Article
- Population size, HIV prevalence, and antiretroviral therapy coverage among key populations in sub-Saharan Africa: collation and synthesis of survey data, 2010-23.The Lancet. Global health · 2024Article
- Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021.Lancet (London, England) · 2024Article
- Methods and Assumptions for Estimating Key HIV Indicators in the UNAIDS Annual Estimates Process.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- The AIDS Epidemic Model 2023 for Estimating HIV Trends and Transmission Dynamics in Asian Epidemic Settings.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Triangulation of Routine Antenatal HIV Prevalence Data and Adjusted HIV Estimates in Mozambique.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Improved Indicators for Subnational Unmet Antiretroviral Therapy Need in the Health System: Updates to the Naomi Model in 2023.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Adult HIV-1 incidence across 15 high-burden countries in sub-Saharan Africa from 2015 to 2019: a pooled analysis of nationally representative data.The lancet. HIV · 2023Article
- Subnational HIV incidence trends in Malawi: large, heterogeneous declines across space.medRxiv : the preprint server for health sciences · 2023Article
- Article
- Incidence of HIV in Sub-Saharan Africa, 2000-2015: The Interplay Between Social Determinants and Behavioral Risk Factors.AIDS and behavior · 2021Article
- Modeling the Impact of Social Determinants of Health on HIV.AIDS and behavior · 2021Article
- Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019.The lancet. HIV · 2021Article
- Updates to Spectrum's case surveillance and vital registration tool for HIV estimates and projections.Journal of the International AIDS Society · 2021Article
- Naomi: a new modelling tool for estimating HIV epidemic indicators at the district level in sub-Saharan Africa.Journal of the International AIDS Society · 2021Article
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Authors and funding
10 authors at 8 institutions in 4 countries.
Funding
Abstract
objectivesImprove models for estimating HIV epidemic trends in sub-Saharan Africa (SSA).
designMathematical epidemic model fit to national HIV survey and ANC sentinel surveillance (ANC-SS) data.
methodsWe modified EPP to incorporate age and sex stratification (EPP-ASM) to more accurately capture the shifting demographics of maturing HIV epidemics. Secondly, we developed a new functional form for the HIV transmission rate, termed 'r-hybrid', which combines a four-parameter logistic function for the initial epidemic growth, peak, and decline followed by a first-order random walk for recent trends after epidemic stabilization. We fitted the r-hybrid model along with previously developed r-spline and r-trend models to HIV prevalence data from household surveys and ANC-SS in 177 regions in 34 SSA countries. We used leave-one-out cross validation with household survey HIV prevalence to compare model predictions.
resultsThe r-hybrid and r-spline models typically provided similar HIV prevalence trends, but sometimes qualitatively different assessments of recent incidence trends because of different structural assumptions about the HIV transmission rate. The r-hybrid model had the lowest average continuous ranked probability score, indicating the best model predictions. Coverage of 95% posterior predictive intervals was 91.5% for the r-hybrid model, versus 87.2 and 85.5% for r-spline and r-trend, respectively.
conclusionThe EPP-ASM and r-hybrid models improve consistency of EPP and Spectrum, improve the epidemiological assumptions underpinning recent HIV incidence estimates, and improve estimates and short-term projections of HIV prevalence trends. Countries that use general population survey and ANC-SS data to estimate HIV epidemic trends should consider using these tools.
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